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IRENE M. BOURGAULT DO PC
NPI 1255511739
Family Medicine in Las Vegas, NV

Active since November 13, 2007
3150 N TENAYA WAY STE 660, LAS VEGAS, NV 89128(702) 648-6228(702) 648-9868 Get Directions Write a Review

NPPES record last updated: December 18, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Irene M. Bourgault Do Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IRENE M. BOURGAULT DO PC (NPI 1255511739) is a healthcare organization registered as a family medicine in Las Vegas, Nevada and active in the NPI registry since November 2007. The organization lists Irene Mary Bourgault, Owner, as its authorized official.

NPPES Registry Identity

NPI1255511739
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameIRENE M. BOURGAULT DO PC
Location Address3150 N TENAYA WAY STE 660Las Vegas, NV 89128-0460
Mailing Address3150 N Tenaya Way Ste 660Las Vegas, NV 89128-0460 · (702) 648-6228 · Fax (702) 648-9868
Phone(702) 648-6228
Fax(702) 648-9868
Organization SubpartNo
Authorized OfficialIrene Mary BourgaultOwner · (702) 648-6228
Enumeration DateNovember 13, 2007
Last NPPES UpdateDecember 18, 2007
✔ NPI 1255511739 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NV · 350
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3150 N TENAYA WAY STE 660, Las Vegas, NV 89128
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Other Identifiers 7

Medicare PIN1740364918NV
OtherV39744NV · Medicare
Medicare UPINC95655NV
OtherV32709NV · Medicare Group
OtherV32710NV · Medicare
Medicare UPINH65342NV
Medicare PIN1164562120NV

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Irene M. Bourgault Do Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Irene M. Bourgault Do PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Irene Bourgault, D.O.
Family Practice
NPI 1164562120
3150 N TENAYA WAY 660
Las Vegas, NV 89128
(702) 648-6228
✔ PECOS✔ Accepts MedicareSame address
Stephanie Casalman, D.O.
Family Practice
NPI 1740364918
3150 N TENAYA WAY #660
Las Vegas, NV 89128
(702) 648-6228
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Irene M. Bourgault Do PC's NPI number?

The NPI number for Irene M. Bourgault Do PC is 1255511739. It was assigned to this organization in the NPPES registry on November 13, 2007.

Where is Irene M. Bourgault Do PC located?

Irene M. Bourgault Do PC is located at 3150 N Tenaya Way Ste 660, Las Vegas, NV 89128. The listed phone number is (702) 648-6228.

What is Irene M. Bourgault Do PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Irene M. Bourgault Do PC enrolled in Medicare?

Yes. Irene M. Bourgault Do PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Irene M. Bourgault Do PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Family Practice, reassign their Medicare billing to Irene M. Bourgault Do PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Irene M. Bourgault Do PC was last updated on December 18, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.